Spring Assembly 2014 - ONWAAFiles!/Training and Assemblies/2014 Spring... · 3 A ONWAA Spring Assembly 2014 Ontario Works Drug Benefit Card Where do you get drug cards? First Nations

Ontario Work Drug Benefit Card

Spring Assembly 2014

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ONWAA Spring Assembly 2014

Ontario Works Drug Benefit Card

Ontario Works Drug Card

First Nation Ontario Works

Administrators play a role in the

provision of health benefits to all

recipients.

First Nation Ontario Works

recipients are eligible to receive a

drug benefit card for drug

coverage monthly. Drug

coverage is limited to items

covered by the Ontario Drug Benefit Program (ODB) and does not include

the co-payment amount.

A drug card may be issued for a

recipient during a period of ineligibility

for assistance due to non-compliance

issues. The First Nation Ontario Works

Administrator may determine a

recipient requires the drug coverage

for a serious illness or health condition

and failure to provide the drug card

would result in a detriment to the

health of a recipient.

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First Nation Ontario Works departments are not responsible for items that

are not covered by Ontario Drug Benefit. For example, opiates are not

covered by Ontario Drug Benefit.

When items are not eligible under the Ontario Benefit Program or Non-

Insured Health Program then the recipient should be referred back to their

physician to speak about their options on how the drugs can be covered.

Any prescriptions that are not covered under the Ontario Works Drug

Benefit Formulary is not eligible as a Director-authorized discretionary

benefit.

Recipients are referred to:

The Exceptional Access Program (EAP)

The New Drug Funding Program (NDFP)

Non Insured Health Benefit Program (NIHB)

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Where do you get drug cards?

First Nations Ontario Works departments will issue the manual drug cards.

The manual Ontario Works drug cards are available through the SAMO

extranet. (http://www.samo.css.gov.on.ca/index.htm)

Step 1

Navigate to the SAMO extranet

(http://www.samo.css.gov.on.ca/index.htm)

Step 2

Scroll down to the page, then click on Resources.

http://www.samo.css.gov.on.ca/index.htm

http://www.samo.css.gov.on.ca/index.htm

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Step 3

An new menu will open. Within this menu, find FORMS, then click on it.

Step 4

A new page will appear. Within this page, click on Ontario Works.

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Step 5

A new page will open, click on Forms Distribution Centre. The Drug Benefit

Eligibility Card –Manual can be order

The Drug Benefit Cards will be sent in bundles of 100. They are carbon

copies. It will take approximately 2-3 weeks (10-15 business days) to receive

them. It is important to have a system for recording how many Ontario

Works Drug Benefit Cards that have been issued.

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Customer Account for Application Forms

The Customer Account for Application Forms is a PDF fillable, enter the

required information and save PDF, then fax to 416-326-8168.

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How to fill out Drug Card

Step 1

Fill out the From and To boxes. Within the From box, you will need to enter the first day

of the month and within the To box, you will need to enter the last day of the month.

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Step 2

Within the Originating Office, you enter the 4 digit code that identifies the

First Nation Ontario Works office. You can find this number on your Form 5.

Step 3

With the box Plan Code, you can enter the letter D.

0 0 0 0

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Step 4

Within the box Eligibility No., you enter the recipient’s Health Card number.

Step 5

Within the First Name and Last Name, you will need to enter the Head of

Household first, then spouse if applicable, then dependents.

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Step 6

You must identify if the Ontario Works Drug Benefit Card is a new card that

is issued or a duplicate. When a Ontario Works Drug Benefit Card is

reported lost or damaged you must check duplicate.

Step 7

Within the Originate office name and location box, you can use your

Ontario Works Commissioner stamp if applicable. If your office does not

have a stamp, the First Nation Ontario Works Administrator can sign within

the Authorizing signature.

A BCR may designate a delegate to have signing authority.

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Drug Benefit Card Log Example

New/

Duplicate

Void

Card

Number

Date of Issue Name Notes

Void 10,000 Not issued N/A Used for Office

purposes

New 10,001 Jan/01/2014 Kim Jones

New 10,002 Jan/01/2014 Brenda King Original

replaced with

card #10,003

Duplicate 10,003 Jan/01/2014 Brenda King Duplicate, card

was washed

Documents

Spring Assembly 2014 - ONWAAFiles!/Training and Assemblies/2014 Spring... · 3 A ONWAA Spring Assembly 2014 Ontario Works Drug Benefit Card Where do you get drug cards? First Nations